Volume 22, Issue 1, March 2011
 
   
Oncology and Primary Care: Informing Each Other

Margaret (Peg) Rosenzweig, PhD, APN-BC, AOCNP®
Sewickley, PA
mros@pitt.edu


The role of the oncology nurse practitioner (NP) allows many unique career opportunities. A wide world of prospects definitely is available to all of us who are looking for a new challenge. I have had a recent opportunity in primary care, a setting quite foreign to me after many years in cancer care.

My journey to primary care started years ago. As a nurse practitioner in cancer care, I recognized that patients of lower socioeconomic status had a more difficult time with the cancer experience than those without great economic challenge. I became very interested in this disparity as it related to patients with advanced breast cancer, and I was fortunate enough to receive research and training support to explore this concept through a mixed qualitative and quantitative study of women with metastatic breast cancer.

The results were intriguing and, at times, heartbreaking. Women of all economic strata with metastatic breast cancer described common challenges of progressive loss, the importance of faith, and the need for hopefulness. Unfortunately, the women of low-income status had great additional burden. Low-income women described fears of losing their home, difficult decisions between affording medication and food, missing clinic appointments because they had no coat for the cold weather, and a sense of profound helplessness and despair. I was affected by the harsh reality of poverty and illness and felt personally compelled to “do something.”

As I was compiling research results, a volunteer-staffed primary care clinic for the working poor opened in the Pittsburgh area. Although I was educated (many years ago!) as a family nurse practitioner, I had only practiced in cancer care. Confident about my NP skills but somewhat nervous about my primary care capabilities, I volunteered conditionally for the biweekly evening clinic. I had the administration’s promise that when I worked, a primary care NP or doctor would always be available to answer questions and review cases. I jumped in.

This opportunity in the clinic for the working poor continues to be challenging. I still prefer cancer care to primary care, but I believe the clinic provides a much needed service and I am happy and proud to participate. When volunteering at the clinic, I am incredibly slow and look everything up. The staff and patients are really kind, and it is nice to care for people who are relatively healthy (although I always worry that everyone has cancer). A surprising secondary benefit is that the experience has not only strengthened my primary care skills but has also helped me to become a better oncology NP.

In the free care clinic, laboratory work is never “stat” and is rarely ordered because of the high patient burden (i.e., complex paperwork) of obtaining “free” radiology. Consequently, I must base clinical decisions on the history and physical alone, rather than relying on radiology or laboratory results that are easily obtained in the cancer clinic. I have to adjust care suggestions to the ever present realities of poverty, such as patients working three jobs or living in a shelter. The difficulty of prescribing affordable medications and the drudgery of applying for the pharmaceutical reimbursement programs makes me acutely aware of medication cost and mindful of “a pill to fix everything” mentality.

These new skills and considerations have strengthened my cancer care practice. Incorporating questions about the cost burden of any intervention I prescribe, better recognizing the importance of tight management of medical comorbidities on cancer care outcomes, and stressing the importance of communication and coordination between the cancer center and the primary care provider are great secondary benefits of my primary care experience. I have also started to ask more often about financial burden among our patients with cancer. I am learning a lot.

Oncology nursing does offer a wide world of opportunity. If we accept the challenges, these opportunities inevitably change and strengthen us as we continue providing care to patients and families with cancer.

 
The Nurse Practitioner SIG Newsletter is produced by members of the
Nurse Practitioner SIG and ONS staff and is not a peer-reviewed publication.

Special Interest Group Newsletter  March 2011
 
   

Speaking of Oysters...

Megan Wholey, RNC, APN-BC, AOCNP®
Arlington, VA
megan.wholey@verizon.net


As Peg’s article exemplifies, our current issue is devoted to describing some of the varied roles we nurse practitioners (NPs) are filling in today’s healthcare settings. My own 22-year practice history includes home health care (where I worked with five other nurses to deliver chemotherapy-to-hospice care for people with cancer and HIV), boarding school (a diversion from working with seriously ill people!), a Veterans Administration medical center, a medical oncology office practice, adjunct teaching, and radiation oncology.

Years ago, I was inspired by reading a biography of Mary Breckenridge, who served on horseback as a frontier nurse in the mountains of Kentucky. Her story resonates with me as an early example of home care and of the pioneering involved in expanding NP practice into new settings.

Home health care can feel like another world, yet definite strength lies in the fact that the nurse is in the patient’s milieu as opposed to being in an impersonal office or institutional setting. For me, the luxury was being able to focus on one individual at a time. Working with a group of nurses committed to quality of life for the patient and family was a great experience. The nurse-owned and operated organization was also focused on communication and committed to the well-being of those of us who were delivering care. For that reason, our census was capped when we reached a complexity-adjusted level based on the nurse manager’s judgment.

Many of us find that as we bring the role to new settings, we have to create our own job descriptions and possibly plan our own orientations! In my history, the boarding school, medical, and radiation oncology settings have all been “first NP” experiences. I had been a student at the boarding school during my final year of high school; this allowed me to understand the school’s philosophy and goals through experience. The local pediatricians were readily available for consultation and worked with me to establish protocols determining which patients could be treated on campus. I interviewed for a “head nurse” position in medical oncology and used that opportunity to pitch my knowledge (gained through the years of homecare experience) that an NP could facilitate many routine scenarios and free up the physician for more complex cases. My experience of more than 15 years in medical oncology helped persuade the radiation oncology group to select me from a highly qualified group of applicants. The fact that few NPs are employed in radiation oncology locally has helped plug me into the wider network of NPs available through ONS and the Radiation Oncology SIG.

My article’s title refers to oysters because I feel grateful for all of the challenges in my years as an oncology NP. I feel they’ve truly been opportunities resulting in “pearls of great price”—the chance to do meaningful work, make a difference in people’s healthcare experiences, and become wiser and more admiring of the people around me. I wouldn’t trade it for the world!

As an end note, this issue of the NP SIG Newsletter will be my last. It’s been a great experience working with other dedicated professionals from around the country. Our co-editor, Karen Overmeyer, will be assuming the editor position. As always, your comments, suggestions, and article requests or submissions are welcome at all times. It was Karen’s idea to add a theme to each newsletter issue, and I believe the resulting “thread” has helped inspire many thoughtful submissions. We’d love wider participation, and we encourage you to write to Karen at Karen.overmeyer@hcahealthcare.com or kadzinski@aol.com with all of your ideas.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Volunteer Help Wanted

SIG Virtual Community Administrator: If you're experienced, tech-savvy, and/or willing to learn, the NP SIG needs you! Please contact Margaret (Peg) Rosenzweig, PhD, APN-BC, AOCNP®, to discuss further or to offer your help.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Thoracic Nurse Practitioner Navigator

Karen Overmeyer, MS, RN, APRN-BC
Mechanicsville, VA
Karen.overmeyer@hcahealthcare.com


Lung cancer currently accounts for more deaths in the United States than any other type of cancer. Although advances in surgical techniques and treatment via multimodal therapies have improved survival, only 15% of lung cancers are detected at an early stage. Overall, only 16% of patients with lung cancer survive for five years or more, regardless of stage at diagnosis (American Cancer Society, 2010).

For the majority of individuals, lung cancer presents at an advanced or locally advanced stage. Many times, lesions are discovered as an incidental finding. Beginning with the first discovery of an abnormal radiograph, patients and families are thrust into a maze of overwhelming choices along the continuum from diagnosis to treatment. High anxiety levels are often coupled with the negative feeling of being unjustly blamed for having lung cancer, even in patients who have never smoked (Sarna et al., 2005). Maneuvering through the healthcare system is confusing, challenging, and time-consuming, and can negatively impact quality of life (Seek & Hogle, 2007).

Using the model of the nurse navigator as the pivotal gatekeeper, our hospital system approved the process for developing a thoracic oncology multidisciplinary clinic coordinated by a nurse practitioner nurse navigator in 2006. The multidisciplinary concept allows for expedited and efficient delivery of services through a personalized, focused approach. Patients and families are linked at the outset with the thoracic nurse navigator (TNN), who collects and reviews all appropriate test results and then plans and coordinates a team of lung specialists and support services to gather at conference to discuss patient data and arrive at an optimal treatment decision. Patients are seen immediately following conference.

Multidisciplinary conferences and clinics (MDC) focus the entire spectrum of cancer management on critical components of specific patients by bringing them face to face at one time in one place. This allows for specialist expertise by looking as a whole at diagnosis, staging, treatment, survivorship, and palliative care (Grusenmeyer, Petrelli, & Stusowski, 2006). Although a paucity of research exists related to the MDC impact on number of days from time of diagnosis to treatment, overall figures suggest the average number of days is 18–29 with MDC versus 48–90 without MDC (Conron et al., 2007; Seek & Hogle, 2007). This is significant in light of studies showing rapid disease progression with delays in treatment of non-small cell lung cancer (Mohammed et al., 2011). TNNs are poised to positively impact the delay in treatment.

In addition to MDC coordination, the TNN serves as the single point of contact for the lung program, functioning as patient and family educator, advocate, symptom manager, and resource director. Other key responsibilities serve the growth and development of the program. Marketing, quarterly assessment of referral channels, collaboration, and maintenance of referral sources require excellent communication and follow-up skills, with sensitivity to physicians who may be concerned about losing control of their patients. New technology evaluation, strategic planning and budgeting, community education, smoking cessation programs, and ongoing evaluation of patient satisfaction as well as quality improvement measures are additional aspects of role performance.

The extensive list of responsibilities is potentially overwhelming, but role satisfaction comes from high autonomy in an integrated practice model where critical clinical decision making and program growth, development, and evaluation are centered on provision of high-quality patient care. Collegial nursing and physician partnerships that are collaboratively focused and working interdependently to create a streamlined, cost effective, and clinically superior whole-systems care delivery model clearly surpasses that of fragmented and often times prolonged steps on the pathway from diagnosis to start of treatment and beyond. Positive outcomes evaluations help make the TNN role very rewarding.

Do I love my job? You bet!

References

American Cancer Society. (2010). Cancer facts and figures 2010. Atlanta, GA: American Cancer Society.

Conron, M., Phuah, S., Steinfort, D., Dabscheck, E., Wright, G., & Hart, D. (2007). Analysis of multidisciplinary lung cancer practice. Internal Medicine Journal, 37, 18-25. doi: 10.1111/j.1445-5994.2006.01237.x

Grusenmeyer, P.A., Petrelli, N.J., & Stusowski, P. (2006). Developing and operating multidisciplinary disease-specific clinics. Community Oncology, 3, 385-387.

Mohammed, N., Kestin, L.L., Grills, I.S., Battu, M., Fitch, D.L., Wong, C.Y., . . . Welsh, R.J. (2011). Rapid disease progression with delay in treatment of non-small-cell lung cancer. International Journal of Radiation Oncology Biology Physics, 79, 466-472.

Sarna, L., Brown J.K., Cooley, M.E., Williams, R.D., Chernecky, C., Padilla, G. & Danao, L.L. (2005). Quality of life and meaning of illness of women with lung cancer [Online Exclusive]. Oncology Nursing Forum, l32, E9–E17. doi: 10.1188/05/ONF.E9-E19

Seek, A.J., & Hogle, W.P. (2007). Modeling a better way: Navigating the healthcare system for patients with lung cancer. Clinical Journal of Oncology, 11, 81-85.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Puzzle Pieces: Pulling It Together for a Cohesive Career

Barbara Biedrzycki, MSN, CRNP, AOCNP®
Baltimore, MD
npbiedrzycki@aol.com


When Megan Wholey, our devoted Nurse Practitioner (NP) SIG Newsletter editor, sent the request for articles on the “Wide World of Oncology NP Practice,” I wasn’t sure if I really wanted to share what I am doing now. Maybe I’ll sound like I’m too fragmented or, worse yet, a failure—not doing the work my education has prepared me for. Then I decided that writing this may actually be therapeutic for me and may even help me find direction. I am not really lost; it’s just that sometimes I feel as if I am going in opposite directions. Oncology NPs have so many wonderful options that I am finding it challenging to focus on just one.

I’ll begin with a little background to catch you up. I received my PhD in May 2010. Many moons ago when I started the PhD program, I imagined that a plethora of fabulous opportunities would await me on completion of the program. Should I choose to be a director of nursing research at a prestigious cancer center, a principal investigator of a well-funded study on decision making and patient-centered care that will change health care as we know it, a tenure-tracked nursing faculty member who is also a national leader among her peers, or an independent nurse practitioner running my own practice? I woke up from that dream about a week after graduation as I scrambled to find work that was meaningful in my employer’s eyes and my own.

So here’s what I do: I provide inpatient medical oncology consultations to people who come in for pancreatic and sometimes other gastrointestinal cancers. Not everyone has his or her intended surgery, as an exploratory laparotomy may indicate metastatic cancer. The consults may be about neoadjuvant, adjuvant, or palliative therapy depending on what has happened since the admission date. The requests may come from the cancer center or the general hospital. At the cancer center, NPs are well-respected and everyone has been supportive of my new role. However, in the hospital every patient seems to have been on a different unit, and when the request is for a unit I have previously visited, the clinical teams are different. Just last week, I met with a patient and family for an hour, and then the resident came in. I briefed him on our discussion, and then he asked me when the oncologist was coming by. I don’t think he really believed me when I told him that I was the medical consult.

These medical consultations may sound routine, but they are anything but rote. Not only are the conditions varied, but every patient and family are different. Some are knowledgeable about the disease that is affecting them, and others are very naïve. During the visits, I usually explain the reason I am there, the patient’s pathology and stage of cancer, data on various options, the available clinical trials, and my recommendations. Many find value in my oncology NP experience and want to know what they can expect. I never introduce the topic of prognosis but will share that information if they ask and really do want to know. More times than I would have thought, when I ask, “Are you sure you want to know about the prognosis?” (or “Are you sure you want to know how long you might have to live?”—I try to use their own words when reframing the question to them), people either burst into tears or quietly say, “No, I am not ready for that yet.” In addition to speaking with patients, I give them written information about their specific cancer and treatment options, as well as the wonderful National Cancer Institute booklets that are appropriate for their needs. These inpatient consultation visits range from 15 to more than 90 minutes in length.

On Tuesdays, I assist with our Pancreas Multidisciplinary Clinic and cover for the coordinator when she is not available. I do history and physical examinations on a few patients and then help with the educational and counseling components of the visit after the diagnosis and treatment recommendations have been presented by the oncologists. This position also suits me well, as many patients are receiving news that they want to talk about, ask questions about, or react to. This nurtures my strong desire to facilitate decision making. (As an aside, my dissertation research was on decision making for cancer clinical trial participation.)

I also have a teaching role at the School of Nursing. In trying to expand my portfolio, last semester I taught first semester junior baccalaureate students at a clinical site and at their clinical laboratory. This required arriving at the clinical site at 6:15 am. I don’t know about you, but it’s been quite a while since I have had to be at work that early in the morning. Despite the early hours, I really enjoyed it. If you ever need a boost, teach first semester nursing students. They are in awe, clinging to every word you say and mimicking your skills and behavior. At first I thought they were hoodwinking me, but I soon believed their admiration was genuine. It’s not that I am so fantastic, it’s just what comes naturally after decades of nursing. I know they would admire you as well! It is a fantastic opportunity to be a mentor for future nurses. (You remember your first clinical instructor, right?)

Teaching was also a good yang to the discussions I regularly have with people recently diagnosed with pancreatic cancer (the yin). It kept my professional life well balanced. But, I can hear someone in the audience whispering, “She’s an NP—why is she teaching first semester nursing students?” Well, that’s just the way it worked out. This spring semester, I am looking forward to teaching in two clinical courses, and one is for NP students.

In trying to build that teaching portfolio, I’ve asked course coordinators to allow me to lecture. Last semester, I taught an interesting class on the female genitourinary system in a health assessment course; this semester, I have scheduled sessions on fatigue for the NP class and clinical research for a baccalaureate class.

That’s my personal wide world of oncology NP practice. Although I am still hoping to get my next research proposal funded, I am keeping the faith and being true to the multifaceted roles of the oncology NP.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Writing and Editing: Who...Me?

Wendy H. Vogel, RN, MSN, FNP, AOCNP®
Bristol, TN
wvogel@charter.net
 

The profession of an oncology nurse practitioner (NP) is anything but dull! There are opportunities for many different professional roles. I never dreamed that I would enjoy professional writing, both as author and as editor. I have had the pleasure of writing for our ONS journals, the Oncology Nursing Forum and the Clinical Journal of Oncology Nursing. Both journals are peer-reviewed and available online to ONS members. I also have had the challenge of coediting an ONS book, Advanced Oncology Nursing Certification Review and Resource Manual. This opportunity allowed me to work closely with advanced practice colleagues and learn from their expertise. Writing for our NP SIG newsletter has also provided me with regular opportunities to address issues that affect our practice as oncology NPs.

A literary venture I am currently experiencing is the chance to participate in the birth of the Journal for the Advanced Practitioner in Oncology, a new professional journal for oncology advanced practitioners (NPs, physician assistants, certified nurse specialists, etc.). This is a free, peer-reviewed journal that just began its second year of publication and complements ONS’s professional journals. As an associate editor, I participate in the planning for each year’s content. I contribute to the shaping of the structure of the journal and brainstorm about what type of columns would interest our colleagues. The associate editor role requires me to recognize hot topics and gaps in our professional literature and requires me to read and grow in areas that I might have otherwise overlooked. I assist in the identification of authors who are clinical experts in certain areas. I have written several articles, and I participate in peer review for submitted papers. In this role, I also have the pleasure of mentoring new writers. The role of an associate editor requires networking with colleagues like you, and that is always lots of fun!

So, are you interested in branching out? Trying out a new role? Maybe you have an idea for an article? Professional writing brings recognition to the role of the oncology NP. Your expertise is valued, and you can share your knowledge, skills, and experience with many via professional writing. There are multiple opportunities right here in our own professional journals. Are you intrigued by this role? Then talk to me sometime or send me an e-mail! You might find a new passion!

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Can Mammograms Cause Breast Cancer?

Wendy H. Vogel, RN, MSN, FNP, AOCNP®
Bristol, TN
wvogel@charter.net


As on oncology nurse practitioner, I often hear from my patients, “I am afraid that mammograms will cause breast cancer.” The American Cancer Society projected that in 2010, 209,060 new cases of breast cancer and about 40,600 deaths would occur (Jemal, Siegel, Xu, & Ward, 2010). With all the focus on breast cancer and early detection, you wouldn’t expect to hear these questions, yet such myths abound. I have a passion for the prevention of cancer—as part of this passion, I write a lay column for my local newspaper addressing myths about cancer causes and treatments. The column has delighted my patients, who love to see someone they know in the newspaper! It has also stimulated a lot of good dialogue about many cancer myths; this, in turn, gives me more fodder for the column. The following article is similar in nature to the lay columns I write for the newspaper. Feel free to cut and paste and copy for your patients!

Do Mammograms Cause Cancer?

Mammograms are recommended for breast cancer screenings beginning at age 40 and continuing yearly. Younger women who are at higher risk for breast cancer may also need yearly mammograms. Breast cancer is a frightening disease, and because of this, many myths exist about its cause. Have you heard the myth that claims mammograms can actually cause cancer?

The myth: For several years, some people have claimed that 75% of all breast cancers could be avoided if women did not get mammograms. The so-called theory behind this myth is that ionizing radiation used to visualize breast tissue is great enough to cause sensitive cellular DNA in the breast to mutate, thus causing cancer. In addition, some claim that the pressure from compressing the breast for the examination could also cause cancer cells to spread. It has even been suggested that the wicked “medical establishment” has “brainwashed” us into allowing ourselves to be “criminally assaulted” by this “medieval torture” for its own financial gain.

The truth: A mammogram is an x-ray of the breast used to look for breast cancer that is too small to find by a breast examination. Mammograms have been used for more than 90 years. An x-ray machine sends a type of electromagnetic radiation through the body. Some of the radiation comes out on the other side of the body, where it exposes film or is absorbed by a digital detector to create an image. It is true that some of this radiation is absorbed in our body tissues. But how much is too much? How much can cause more harm than good?

We are exposed to naturally occurring radiation daily. The yearly dose we are exposed to naturally is about 3 millisievert (mSv). A mammogram gives us about 0.7 mSv or what we would typically be exposed to in about three months in our own backyards. This low level of radiation is determined safe by the American College of Radiology (ACR). It would take 100–1,000 times these radiation doses to show any statistical increase in the occurrence of breast cancer. ACR created the Mammography Quality Standards Act, passed by Congress in 1992, which mandates strict guidelines for x-ray safety during mammography.

The radiation exposure of mammography is so small that the benefits far outweigh the risks. Mammograms are the most accurate way of detecting breast cancer, and they find about 80%–90% of breast cancers. (No test is 100% effective.) Although mammograms do not prevent breast cancer, they can detect cancer at its earliest stage while it is still curable. A mammogram may find breast cancer as early as a year or two before you or your healthcare provider could feel it. If breast cancer is found in a localized stage, the five-year survival rate is 98%. However, if breast cancer is found in the last stage (when it has metastasized), the five-year survival rate is only about 23%. In addition to mammography, women should also have breast examinations performed by their healthcare provider yearly. Breast self-examinations done monthly can also help detect breast cancer early.

What about the danger of compressing the breasts? No evidence has shown that any type of injury, including compression, will cause cancer to occur or spread. And what about digital mammography—is it safer? Both regular mammography and digital mammography use x-rays to evaluate the breast, but digital mammography stores the electronic image on a computer and regular mammography stores it on film; this is similar to the difference between a digital camera and film camera. The advantage of digital mammography is that subtle differences may be noted more easily and fewer follow-up images might be needed, thus lessening the total radiation exposure.

So the bottom line is “stay abreast” of the truth in order to “keep a breast.” Do your breast self-examinations, see your healthcare provider for clinical breast examinations, and if you are age 40 or older, get your mammogram—and worry about something else!

Reference

Jemal, A., Siegel, R., Xu, J., & Ward, E. (2010). Cancer statistics, 2010. CA: A Cancer Journal for Clinicians, 60, 277–300. doi: 10.3322/caac.20073

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Lung Cancer Screening at Last?

Karen Overmeyer, MS, RN, APRN-BC
Mechanicsville, VA
Karen.overmeyer@hcahealthcare.com


Lung cancer remains the leading cause of cancer-related deaths in the United States, surpassing breast, prostate, and colon cancer combined. The links between cigarette smoking and incidence of lung cancer began to emerge as early as 1948; since that time, both smoking and second- and third-hand smoke have been proven contributors (Jemal, Siegel, Xu, & Ward, 2010). Although smoking rates have decreased in recent years, with a subsequent decrease in lung cancer mortality, the risk for developing lung cancer remains significantly higher for former smokers relative to individuals who have never smoked. To date, no effective method of screening for lung cancer has been available; therefore, the majority of individuals newly diagnosed are at advanced clinical stages with poor prognosis.

In November 2010, the National Cancer Institute (NCI) released the initial results of the randomized National Lung Screening Trial (NLST), which showed statistically significant evidence that early detection of lung cancer could reduce lung cancer deaths by at least 20% (NLST Research Team, 2011). The study, which began in 2002, was the largest of its kind and involved 53,456 current or previous heavy smokers, aged 55–74 years, recruited by and enrolled in 33 screening centers across the United States. Individuals were randomized to receive either low-dose helical chest computed tomography (CT) or chest radiography, with lung cancer mortality as the primary endpoint of the study.

A partial list of inclusion criteria were being age 55–74 years, having a 30 pack-year or more smoking history, and having no previous lung cancer, lung resection, or acute pulmonary conditions.

Images were reviewed to identify masses, lung nodules, abnormalities, or clusters of abnormalities suspicious for lung cancer. All participants with positive findings received follow-up. An endpoint verification algorithm was used to ascertain deaths caused by lung cancer as well as deaths from adverse outcomes of the screening process.

Although the study showed a 20.3% reduction in lung cancer mortality associated with the low-dose helical CT group compared to those receiving chest x–ray, possible disadvantages included mild but cumulative radiation effects from multiple CT scans, surgical and medical complications incurred secondary to additional testing required to work up positive findings, and the elements of anxiety and expense. Other areas still being assessed include all-cause mortality, lung cancer stage at diagnosis, adverse effects, healthcare usage, quality of life, and cost effectiveness.

One should bear in mind that these results reflect a particular population, excluding people who have never smoked, the young, and older adults. Much is yet to be learned; however, final results of this landmark study will hopefully lead to a fundamental change in screening policy in the United States with a positive shift in how insurers and the medical community view early detection.

The NLST publication is openly available online. For additional resources, visit NCI’s Web site.

Reference

Jemal, A., Siegel, R., Xu, J., & Ward, E. (2010). Cancer statistics, 2010. CA: A Cancer Journal for Clinicians, 60, 277–300. doi: 10.3322/caac.20073

National Lung Screening Trial Research Team. (2011). The National Lung Screening Trial: Overview and study design. Radiology, 258, 243–253. doi: 10.1148/radiol.10091808

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

RE:Connect

RE:Connect is a blog written by oncology nurses on a variety of topics of interest to other nurses in the specialty, including facing day-to-day challenges at work, juggling busy lives at home, and keeping up to date with the magnitude of information available for practicing nurses. This month on RE:Connect, you’ll find discussions titled New Research in Breast Cancer Surgery: Evidence, Feelings, and Relationships, Oh My!, Do You Send Sympathy Cards to Families?, and Reading Material: The Good, the Bad, and the Easy. As a reader, join in on the conversation and connect with other oncology nurse readers by posting your own stories, tips, ideas, and suggestions in the comments section at the end of each blog post.
 
Back to SIG Newsletter front page
 

 
 

Special Interest Group Newsletter  March 2011
 
   

Five-Minute In-Service

In the latest issue of ONS Connect, the Five-Minute In-Service takes a look at An Introduction to Li-Fraumeni Syndrome, which appeared in the February 2011 issue of the Clinical Journal of Oncology Nursing.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

ONS Podcasts of Interest

CJONPlus Podcast
In this installment of CJONPlus, Amy Edgington, RN, NP-BC, and Mary Ann Morgan, PhD, FNP-BC, discuss nursing strategies for assessing and addressing comorbid conditions as a vital part of oncology care. Listen in as Ms. Edgington and Dr. Morgan are interviewed about their February 2011 CJON article "Looking Beyond Recurrence: Comorbidities in Cancer Survivors."
 
Back to SIG Newsletter front page
 

 
 

Special Interest Group Newsletter  March 2011
 
   

Help Improve Evidence-Based Practice: Get Involved in PEP

Do you want to help make evidence readily available to nurses in oncology practice? Do you want to easily stay up to date with all of the evidence in particular PEP topic areas or learn more about summarizing and critically appraising evidence? Become a PEP topic contributor or reviewer today. Those who participate in PEP activities are eligible for ONC-Pro points on an annual basis. Contact us to learn more about how you can become involved today.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Make Sure You're Getting the Latest SIG Info!

All SIG newsletters and communiqués are posted to their respective SIG Virtual Community, and members with valid e-mail addresses receive notification when the latest newsletters and communiqués are posted. ONS no longer distributes via U.S. mail hard copy printouts of the SIG newsletters and communiqués to members who have not provided a valid e-mail address.

If you currently are not receiving e-mails from ONS, please go to www.ons.org and select “login.” Enter your username and password (or, if you do not have a profile, select “Create One Now”). Once you are logged in, go to your profile and select “My Personal Info.” Here you can add or change your e-mail address in our database.

If you wish to receive SIG correspondence but not other e-mails from ONS, select “My Preferences” on the left, and then, select “Manage Subscriptions” under “E-mail Preferences.” From this page, you can select any kind of e-mail that you do NOT want to receive. You still will receive your SIG information as part of your membership as long as we have a valid e-mail address on file for you.

If you do not provide an e-mail address, you will not be notified when a new SIG newsletter or communiqué is posted. However, you always can access newsletters and communiqués by going to your SIG’s Virtual Community.

 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Membership Information

SIG Membership Benefits

  • Network with colleagues in an identified subspecialty area around the country.
  • Contribute articles for your SIG’s newsletter.
  • Participate in discussions with other SIG members.
  • Contribute to the future path of the SIG.
  • Share your expertise.
  • Support and/or mentor a colleague.
  • Receive information about the latest advancements in treatments, clinical trials, etc.
  • Participate in ONS leadership by running for SIG coordinator-elect or join SIG work groups.
  • Acquire information with a click of a mouse at http://ons.org/membership including
    • Educational opportunities for your subspecialty
    • Education material on practice
    • Calls to action
    • News impacting or affecting your specific SIG
    • Newsletters
    • Communiqués
    • Meeting minutes.

Join a Virtual Community

A great way to stay connected to your SIG is to join its Virtual Community. It’s easy to do so. All you will need to do is

  • Log on to the ONS Web site (http://www.ons.org/).
  • Select "Membership" from the tabs above.
  • Then, click on "ONS Chapters and Special Interest Groups."
  • Scroll down to "Visit the ONS Special Interest Groups (SIG) Virtual Community" and click.
  • Now, select "Find a SIG."
  • Locate and click on the name of your SIG from the list of all ONS SIGs displayed.
  • Once the front page of your SIG’s Virtual Community appears on screen, select "New User" from the top left. (This allows you to create log-in credentials.)
  • Type the required information into the text fields as prompted.
  • Click "Join Group" (at the bottom right of the text fields) when done.

    Special Notices


    • If you already have log-in credentials generated from the ONS Web site, use this information instead of attempting to generate new information.
    • If you created log-in credentials for the ONS Web site and wish to have different log-in information, you will not be able to use the same e-mail address to generate your new credentials. Instead, use an alternate e-mail address.

Subscribe to Your SIG’s Virtual Community Discussion Forum
Once you have your log-in credentials, you are ready to subscribe to your SIG’s Virtual Community discussion forum. To do so,

  • Select "Log In," located next to "New User," and enter your information.
  • Next, click on the "Discussion" tab on the top right of the title bar.
  • Locate and select "Subscribe to Discussion"
  • Enter e-mail address.
  • Click "Finish."
  • You are now ready to begin participating in your SIG’s discussion forum.

Participate in Your SIG’s Virtual Community Discussion Forum

  • First, log in. (This allows others to identify you and enables you to receive notification [via e-mail] each time a response or new topic is posted.)
  • Click on "Discussion" from the top title bar.
  • Click on any posted topic to view contents and post responses.

Sign Up to Receive Your SIG’s Virtual Community Announcements
As an added feature, members also are able to register to receive their SIG’s announcements by e-mail.

  • From your SIG’s Virtual Community page, locate the "Sign Up Here to Receive Your SIG’s Announcements" section.
  • Select the "Click Here" feature, which will take you to a link to subscribe.
  • Once the "For Announcement Subscription Only" page appears select how you wish to receive your announcements.
    • As individual e-mails each time a new announcement is posted
    • One e-mail per day comprised of all new daily announcements posted
    • Opt-out, indicating that you will frequently browse your SIG’s Virtual Community page for new postings
  • Enter your e-mail address.
  • Click on "Next Page."
  • Click "Finish"
  • You are now subscribed to receive announcements.
 
 
Back to SIG Newsletter front page
 
 
 

Special Interest Group Newsletter  March 2011
 
   

Nurse Practitioner SIG Officers

Coordinator (2010–2012)
Margaret (Peg) Rosenzweig, PhD, APN-BC, AOCNP®
Sewickley, PA
mros@pitt.edu

Ex-Officio (2010–2011)
Barbara Biedrzycki, MSN, CRNP, AOCNP®
Baltimore, MD
npbiedrzycki@aol.com

Editor
Megan Wholey, RNC, ANP-BC, AOCNP®
Arlington, VA
megan.wholey@verizon.net

Co-Editor
Karen Overmeyer, MS, RN, APRN-BC
Mechanicsville, VA
Karen.overmeyer@hcahealthcare.com

 

Web Page Administrator
Open Position

Legislative Issues
Wendy H. Vogel, RN, MSN, FNP, AOCNP®
Bristol, TN
wvogel@charter.net

Archives
Barbara Biedrzycki, RN, MSN, CRNP, AOCNP®
Baltimore, MD
npbiedrzycki@aol.com

ONS Copy Editor
Ben Berkey, BS
Pittsburgh, PA
bberkey@ons.org

Know someone who would like to receive a print copy of this newsletter?
To print a copy of this newsletter from your home or office computer, click here or on the printer icon located on the SIG Newsletter front page. Print copies of each online SIG newsletter also are available through the ONS National Office. To have a copy mailed to you or another SIG member, contact Membership/Leadership Specialist Carol DeMarco at cdemarco@ons.org or 866-257-4ONS, ext. 6230.

View past newsletters.

ONS Membership & Component Relations Department Contact Information

Brian K. Theil, CAE, Director of Membership
btheil@ons.org
412-859-6244

Diane Scheuring, MBA, CAE, CMP, Manager of Member Services
dscheuring@ons.org
412-859-6256

Carol DeMarco, Membership/Leadership Specialist
cdemarco@ons.org
412-859-6230

The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability.

Oncology Nursing Society
125 Enterprise Dr.
Pittsburgh, PA 15275-1214
866-257-4ONS
412-859-6100
www.ons.org

 
 
Back to SIG Newsletter front page